BACKGROUND OF THE INVENTION
Field of the Invention
[0001] The present invention relates to a high-frequency treatment instrument.
Description of the Related Art
[0003] As a treatment method of removing a biological tissue such as a mucous membrane by
the use of an endoscope, an endoscopic submucosal dissection (ESD) method of cutting
out a normal mucous membrane around a pathological lesion portion and then dissecting
a submucosal layer to remove or the like the pathological lesion portion so as to
remove the pathological lesion portion generated on a surface of an alimentary canal
is known.
[0006] However, in the known high-frequency treatment instrument, the knife portion is configured
to extend in an advance and retreat direction thereof. Accordingly, when the knife
portion is brought into contact with a subject tissue to cut out the subject tissue,
it is necessary to secure a contact area between the subject tissue. Therefore, a
curving operation and an advance and retreat operation of an endoscope as well as
an advance and retreat operation of the treatment electrode are necessary for the
dissection. In this case, an observation and operations using the endoscope should
be simultaneously performed and close attention and high-level operation techniques
are required for the each operation.
[0007] Document
EP 0 624 348 A2 discloses a bipolar electrosurgical instrument comprising a handle assembly. An elongated
body portion extends from the handle assembly. Attached at a distal end of the body
portion is a tool mechanism comprising a pair of scissor blades. A stationary scissor
blade is pivotally connected to a movable scissor blade which rotates about a transverse
pivot pin. A mechanism connects the tool mechanism to the handle. An inner rod having
a transverse bearing post is adapted for a longitudinal reciprocal motion. The bearing
post interfits with a slot of the stationary scissor blade and with an angled cam
slot of the movable blade. A longitudinal motion of the inner rod translates into
a pivotal motion of a scissor blade about the pivot pin.
[0008] Document
US 2004/0172018 A1 discloses an endoscopic treatment instrument, in particular a diathermic cutter.
The cutter comprises an elongated flexible sheath having a cutter section at the distal
end of the sheath. The cutter section is provided with a rod-shaped electrode portion
projecting axially from the distal end of the sheath. A bend portion that is bend
substantially at right angles is formed at the distal end portion of the rod-shaped
electrode portion.
[0009] The invention is made in view of the above-mentioned problems. An object of the invention
is to provide a high-frequency treatment instrument which can facilitate a procedure
by enabling a treatment on a subject tissue without performing a curving operation
of an endoscope.
SUMMARY OF THE INVENTION
[0010] The invention employs the following devices to accomplish the above-mentioned object.
[0011] In a first aspect of the present invention, there is provided a high-frequency treatment
instrument for performing a high-frequency treatment on a subject tissue, the high-frequency
treatment instrument includes an elongated extension member; and a treatment electrode
that is rotatably connected to a distal end of the elongated extension member and
that has a knife portion extending substantially parallel to a diameter direction
of the rotation.
[0012] According to the first aspect of the invention, it is possible to bring the knife
portion into contact with the subject tissue with an appropriate contact area by adjusting
an angle of the knife portion relative to the elongated extension member.
[0013] In a second aspect of the high-frequency treatment instrument of the present invention,
the high-frequency treatment instrument includes the treatment electrode in which
a pair of electrode pieces that rotate reversely to each other around the same rotation
center is provided. In this case, each of the pair of electrode pieces has the knife
portion.
[0014] According to the second aspect of the invention, the knife portions can be arranged
linearly by allowing the pair of electrode pieces to rotate around a rotation center,
thereby securing a large cut-out surface using the knife portions.
[0015] In a third aspect of the high-frequency treatment instrument of the present invention,
the high-frequency treatment instrument includes the elongated extension member of
a tube shape. The high-frequency treatment instrument further includes an axial member
that is rotatably connected to the treatment electrode and that advances and retreats
relative to the elongated extension member to rotate the treatment electrode.
[0016] According to the third aspect of the invention, it is possible to allow the treatment
electrode to rotate and to change the direction of the knife portion by allowing the
axial member to advance and retreat relative to the elongated extension member.
[0017] In fourth aspect of the high-frequency treatment instrument of the present invention,
the high-frequency treatment instrument includes the knife portion which rotates from
a state where the knife portion is substantially parallel to a center line direction
of the elongated extension member to a state where the knife portion is substantially
perpendicular to the center line direction.
[0018] According to the fourth aspect of the invention, in the state where the knife portion
is substantially parallel to the center line of the elongated extension member, even
when the knife portion is elongated, the length of the treatment electrode increases
in the center line direction of the elongated extension member, thereby it is possible
to insert the knife portion into a treatment instrument channel of an endoscope. On
the other hand, in the state where the knife portion is rotated to be substantially
perpendicular to the center line of the elongated extension member, it is possible
to sufficiently secure the contact area which contacts the subject tissue.
[0019] In a fifth aspect of the high-frequency treatment instrument of the present invention,
the high-frequency treatment instrument includes the knife portion in which a length
thereof is greater than the outer diameter of the elongated extension member.
[0020] According to the fifth aspect of the invention, since the knife portion has a length
longer than the outer diameter of the elongated extension member, it is possible to
sufficiently secure the contact area which contacts the subject tissue. In addition,
by arranging the knife portion to be substantially parallel to the center line of
the elongated extension member, it is possible to house the knife portion in the elongated
extension member.
[0021] In a sixth aspect of the high-frequency treatment instrument of the present invention,
there is provided a high-frequency treatment instrument for performing a high-frequency
treatment on a subject tissue, the high-frequency treatment instrument includes: a
sheath; an axial member disposed in the sheath so as to freely advance and retreat
and to freely rotate; and a treatment electrode that is disposed at a distal end of
the axial member so as to advance and retreat in the sheath along with the axial member
and that has a knife portion extending in a direction substantially perpendicular
to a center line of the axial member as the axial member being a center.
[0022] According to the sixth aspect of the invention, since the knife portion of the treatment
electrode extends in a direction substantially perpendicular to the axial member,
it is possible to increase the contact area between the treatment electrode and the
subject tissue. By allowing the axial member to advance and retreat, it is possible
to bring the knife portion into contact with the subject tissue with an appropriate
contact area.
[0023] According to the invention, it is possible to facilitate a procedure by enabling
a treatment on a subject tissue without performing a curving operation of an endoscope.
BRIEF DESCRIPTION OF THE DRAWINGS
[0024] FIG. 1 is a partially sectional schematic view illustrating a whole high-frequency
treatment instrument according to a first embodiment of the invention.
[0025] FIGS. 2A is a partially sectional plan view of substantial part illustrating the
high-frequency treatment instrument according to the first embodiment of the invention.
[0026] FIG. 2B is a partially-sectional front view of substantial part illustrating the
high-frequency treatment instrument according to the first embodiment of the invention.
[0027] FIG. 3 is a partially-sectional side view of substantial part illustrating the high-frequency
treatment instrument according to the first embodiment of the invention.
[0028] FIG. 4 is an explanatory diagram illustrating a usage example of the high-frequency
treatment instrument according to the first embodiment of the invention.
[0029] FIG. 5 is an explanatory diagram illustrating a usage example of the high-frequency
treatment instrument according to the first embodiment of the invention.
[0030] FIG. 6 is an explanatory diagram illustrating a usage example of the high-frequency
treatment instrument according to the first embodiment of the invention.
[0031] FIG. 7 is an explanatory diagram illustrating a usage example of the high-frequency
treatment instrument according to the first embodiment of the invention.
[0032] FIG. 8 is a partially sectional schematic view illustrating a whole high-frequency
treatment instrument according to a second embodiment of the invention.
[0033] FIG. 9 is a partially sectional plan view of substantial part illustrating the high-frequency
treatment instrument according to the second embodiment of the invention.
[0034] FIG. 10 is a partially sectional side view of substantial part illustrating the high-frequency
treatment instrument according to the second embodiment of the invention.
[0035] FIG. 11 is a partially sectional plan view of substantial part illustrating the high-frequency
treatment instrument according to the second embodiment of the invention.
[0036] FIG. 12 is a partially sectional schematic view illustrating a whole high-frequency
treatment instrument according to a third embodiment of the invention.
[0037] FIG. 13 is a partially sectional schematic view illustrating a whole modified example
of the high-frequency treatment instrument according to the third embodiment of the
invention.
[0038] FIG. 14 is a partially sectional plan view of substantial part illustrating the high-frequency
treatment instrument according to the first embodiment of the invention.
[0039] FIG. 15 is a partially-sectional plan view of substantial part illustrating a modified
example of the high-frequency treatment instrument according to the first embodiment
of the invention.
DETAILED DESCRIPTION OF THE INVENTION
[0040] A first embodiment of the invention will be described with reference to FIGS. 1 to
7.
[0041] A high-frequency treatment instrument 1 according to the first embodiment of the
invention is a high-frequency treatment instrument for performing a high-frequency
treatment on a pathological lesion portion (subject tissue) not shown and includes
a sheath (elongated extension member) 2, a treatment electrode 5 that is rotatably
disposed at a distal end of the sheath 2 and that has a knife portion 3 extending
in a direction substantially parallel to a diameter direction of the rotation, an
operating wire (axial member) 6 for allowing the treatment electrode 5 to rotate around
the distal end of the sheath 2, and an operating section 7 to which proximal ends
of the sheath 2 and the operating wire 6 are connected, as shown in FIGS. 1 to 3.
[0042] The sheath 2 includes a coil sheath 2A in which a coil is wound to form a tube shape
and a resin tube 2B which covers the coil sheath 2A. On the distal end of the sheath
2, a distal end support portion 8 which is disposed to protrude along a center line
C of the sheath 2 and which rotatably supports the treatment electrode 5, is connected.
[0043] The treatment electrode 5 includes a pair of electrode pieces 11A and 11B that are
connected to a distal end support 8 via an axis of rotation 10 and that rotate reversely
to each other using the axis of rotation 10 as the same rotation center. Linear knife
portions 3 are formed in the electrode pieces 11A and 11B. respectively. The knife
portions 3 have a length substantially equal to the outer diameter of the sheath 2.
When the knife portions 3 are made to rotate around the axis of rotation 10 from a
state where the knife portions 3 are substantially parallel to the center line C of
the sheath 2 to a state where the knife portions 3 are substantially perpendicular
to the center line, the knife portions 3 are arranged linearly to form a cut-out surface
3A having a length substantially twice as long as the outer diameter of the sheath
2.
[0044] The length of the cut-out surface 3A is not limited to twice the outer diameter of
the sheath 2, but may be any length which is longer than the outer diameter of the
sheath 2.
[0045] A pair of electrode pieces 11 A and 11B is provided with a stopper 12 for stopping
the relative rotation thereof at the time of forming the cut-out surface 3A. The stopper
12 includes a convex portion 12A formed in the electrode piece 11A and a notch portion
12B formed in the electrode piece 11B on which the convex portion 12A is locked.
[0046] The operating wire 6 is disposed in the sheath 2 so as to freely advance and retreat.
The distal end side of the operating wire 6 is branched into a first wire 6A rotatably
connected to the electrode piece 11A and a second wire 6B rotatably connected to the
electrode piece 11B. The first wire 6A and the second wire 6B are provided with a
plurality of bent portions 13 which intersect each other in the sheath 2.
[0047] The operating section 7 includes an operating portion body 15 connected to a proximal
end of the resin tube 2B and a slider 16 connected by a proximal end of the sheath
2 so as to freely slide relative to the operating portion body 15. An electrode terminal
17 electrically connected to the operating wire 6 and connected to a connection cable
extending from a high-frequency power source not shown is disposed in the slider 16.
[0048] Next, operations of the high-frequency treatment instrument I will be described with
reference to a procedure of removing a pathological lesion portion X generated on
the surface of an alimentary canal by dissecting a submucosal layer W by the use of
the high-frequency treatment instrument 1 according to this embodiment.
[0049] First, as shown in FIG. 4, an injection needle Si is introduced into a body cavity
through a treatment instrument channel of an endoscope not shown and a physiologic
saline solution is locally injected into the submucosal layer W around the pathological
lesion portion X to be removed, thereby distending the pathological lesion portion
X as shown in FIG. 5. Before performing the local injection, it is preferable that
a dye be applied around the pathological lesion portion X to clarify the boundary
of the pathological lesion portion X, and then a mucous membrane S is marked at a
plurality of positions surrounding the circumference of the pathological lesion portion
X by the use of an existing high-frequency knife HK.
[0050] Next, the existing high-frequency knife HK is inserted through the treatment instrument
channel and is brought into contact with a part of the mucous membrane S in the vicinity
of the pathological lesion portion X as shown in FIG. 6, and a hole H which is a start
point of the entire peripheral cut-out is formed by supplying high-frequency current
thereto. By operating both the endoscope and the high-frequency knife HK, the mucous
membrane around the pathological lesion portion X is cut out to expose the submucosal
layer W.
[0051] Then, the high-frequency knife is pulled out of the cannel and the sheath 2 of the
high-frequency treatment instrument 1 is inserted into the channel. At this time,
the slider 16 of the high-frequency treatment instrument 1 is made to retreat relative
to the operating portion body 15, whereby the knife portions 3 of the pair of electrode
pieces 11A and 1 I B are set to be substantially parallel to the center line C of
the sheath 2 as shown in FIG. 2.
[0052] The treatment electrode 5 is exposed from the channel and then the slider 16 is made
to move toward the distal end of the operating portion body 15. At this time, since
the operating wire 6 advances relative to the sheath 2, the first wire 6A presses
the electrode piece 11A and the second wire 6B presses the electrode piece 11B. Then,
the electrode piece 11A rotates around the axis of rotation 10 in the counterclockwise
direction in the drawing and the electrode piece 11B rotates in the clockwise direction.
In this way, the linear cut-out surface 3A in a direction substantially perpendicular
to the center line C of the sheath 2 is formed.
[0053] High-frequency current is made to flow while the cut-out surface 3A is brought into
contact with the submucosal layer W, and the sheath 2 of the high-frequency treatment
instrument 1 is made to advance relative to the channel while observing with the endoscope.
When the cut-out angle is to be changed, the operating portion 7 is made to rotate
relative to the resin tube 2B. At this time, a rotation torque is transmitted to the
treatment electrode 5 via the coil sheath 2A and the operating wire 6 and thus the
treatment electrode rotates around the center line C, thereby changing the direction
of the cut-out surface 3A. In this way, as shown in FIG. 7, the submucosal layer W
is cut out and the pathological lesion portion X is dissected by the cut-out surface
3A.
[0054] According to the high-frequency treatment instrument 1, it is possible to adjust
the contact angle between the cut-out surface 3A of the knife portions 3 and the pathological
lesion portion X by rotating the treatment electrode 5 around the axis of rotation
10 and to bring the cut-out surface 3 A of the knife portions 3 into contact with
the pathological lesion portion X with an appropriate contact area by allowing the
sheath 2 to advance and retreat relative to the endoscope. Accordingly, it is possible
to enable a treatment on the pathological lesion portion X without performing a curving
operation of the endoscope, thereby facilitating the procedure.
[0055] In the state where the knife portions 3 are substantially parallel to the center
line C of the sheath 2, even when the knife portions 3 are elongated, the length of
the treatment electrode 5 increases in the center line C direction of the sheath 2,
thereby the high-frequency treatment instrument can be inserted into the channel of
the endoscope. On the other hand, in the state where the knife portions 3 are rotated
to be substantially perpendicular to the center line C of the sheath 2, it is possible
to sufficiently secure the contact area which contacts the pathological lesion portion
X.
[0056] Next, a second embodiment of the invention will be described with reference to FIGS.
8 to 11.
[0057] The same elements as the first embodiment are denoted by the same reference numerals
and description thereof will be omitted.
[0058] The second embodiment is different from the first embodiment, in that a treatment
electrode 21 of a high-frequency treatment instrument 20 according to the second embodiment
has only one electrode piece 22, as shown in FIGS. 8 to 10.
[0059] A sheath 23 has a coil sheath 23A and a resin tube 23B disposed therein so as to
freely advance and retreat with each other. A distal end support portion 25 is connected
to a distal end of the coil sheath 23A. The distal end of the resin tube 23B is provided
with a locking portion 26 which restricts the protrusion of the coil sheath 23A from
the distal end of the resin tube 23B.
[0060] The electrode piece 22 has the same shape as the electrode piece I 1A according to
the first embodiment. A knife portion 27 is formed by allowing a part of a linear
portion of the electrode piece 22 to further protrude linearly in the same direction.
An operating wire 28 is connected to the electrode piece 22 in a line extending from
the proximal end side of the knife portion 27.
[0061] An operating portion 30 includes a tube-shaped first slider 31 of which the distal
end is connected to the proximal end of the resin tube 23B, a rod-shaped operating
portion body 32 to which the proximal end of the coil sheath 23A is connected, and
a second slider 33 to which the proximal end of the operating wire 28 is connected.
The first slider 31 slidably covers to the outer peripheral surface of the operating
portion body 32 with an O ring 35 interposed therebetween. The second slider 33 is
slidably connected to the first slider 31 and the operating portion body 32. The electrode
terminal 17 is disposed in the second slider 33. A finger laying portion 18 is disposed
at the proximal end of the operating portion body 15.
[0062] Next, operations of the high-frequency treatment instrument 20 according to this
embodiment will be described.
[0063] First, similarly to the first embodiment, a physiologic saline solution is locally
injected into a submucosal layer around a pathological lesion portion to be removed,
thereby distending the pathological lesion portion.
[0064] Then, the second slider 33 is made to retreat relative to the operating portion body
32 of the high-frequency treatment instrument 20.
[0065] At this time, the electrode piece 22 rotates around the axis of rotation 10 in a
counterclockwise direction in the drawing, whereby the knife portion 27 is substantially
parallel to the center line C of the sheath 23. In this state, when the operating
portion body 32 is made to retreat relative to the first slider 31, the treatment
electrode 21 is further housed in the resin tube 23B, as shown in F1G. 11.
[0066] In this state, the sheath 23 is inserted into a treatment instrument channel of an
endoscope not shown. Then, the distal end side of the resin tube 23B is exposed from
the channel in the vicinity of the pathological lesion portion and the operating portion
body 32 along with the second slider 33 is made to move to the distal end side of
the operating portion body 32 relative to the first slider 31 until the coil sheath
23A comes in contact with the locking portion 26. At this time, as shown in FIG. 9,
the treatment electrode 21 protrudes from the distal end of the sheath 23.
[0067] After the coil sheath 23A comes in contact with the locking portion 26, the distal
end of the knife portion 27 is brought into contact with a part of the mucous membrane
in the vicinity of the pathological lesion portion and then high-frequency current
is supplied thereto, thereby forming a hole which is a start point of the entire peripheral
cut-out. Then, by individually operating the endoscope and the high-frequency treatment
instrument 20, the submucosal layer is exposed while the mucous membrane around the
pathological lesion portion is cut out.
[0068] Subsequently, the second slider 33 is made to move to the distal end side of the
operating portion body 32. At this time, since the operating wire 28 advances relative
to the coil sheath 23A, the operating wire 28 presses the electrode piece 22. Then,
the electrode piece 22 rotates around the axis of rotation 10 in the clockwise direction
in the drawing and the knife portion 27 is extended in a direction substantially perpendicular
to the center line C of the sheath 23, as shown in FIG. 8.
[0069] The high-frequency current is made to flow thereto while the knife portion 27 is
brought into contact with the submucosal layer and the sheath 23 of the high-frequency
treatment instrument 20 is made to advance relative to the channel while observing
with the endoscope. When the cut-out angle is to be changed, the operating portion
body 32 is made to rotate relative to the first slider 31. In this way, the submucosal
layer is cut out to dissect the pathological lesion portion, similarly to the first
embodiment.
[0070] According to the high-frequency treatment instrument 20, when the knife portion 27
becomes substantially parallel to the center line C of the sheath 23, the knife portion
27 can pass in and out of the sheath 23. Accordingly, similarly to the existing high-frequency
knife, it is possible to form a hole around the pathological lesion portion. On the
other hand, when the knife portion 27 becomes substantially perpendicular to the center
line C, the same advantages as the first embodiment can be obtained.
[0071] Since the treatment electrode 21 has only one electrode piece 22, it is possible
to simplify the distal side configuration of the treatment instrument.
[0072] Next, a third embodiment of the invention will be described with reference to FIG.
12.
[0073] The same elements as the above-mentioned embodiments are denoted by the same reference
numerals and description thereof will be omitted.
[0074] The third embodiment is different from the first embodiment, in that a treatment
electrode 41 of a high-frequency treatment instrument 40 according to the third embodiment
is disposed at a distal end of an operating wire 42 so as to advance and retreat in
the sheath 2 along with the operating wire 42 and a knife portion 43 is disposed to
extend in a direction substantially perpendicular to a center line C of the operating
wire 42.
[0075] The treatment electrode 41 includes the knife portion 43 and a rod-shaped relay portion
45 which is connected to the operating wire 42. The center of the knife portion 43
is connected to the distal end of the relay portion 45. The knife portion 43 has a
length substantially equal to the inner diameter of the sheath 2. The operating wire
42 and the relay portion 45 are connected to each other via a connection member 46.
[0076] A control portion 47, which is provided with a through-hole 47a having such a size
to allow the relay portion 45 to pass therethrough and not to allow the knife portion
43 and the connection member 46 to pass therethrough, is disposed at the distal end
of the sheath 2. That is, the operating wire 42 and the treatment electrode 41 freely
rotate relative to the sheath 2.
[0077] Next, operations of the high-frequency treatment instrument 40 according to this
embodiment will be described.
[0078] First, similarly to the first embodiment, a physiologic saline solution is locally
inserted into a submucosal layer around a pathological lesion portion to be removed,
thereby distending the pathological lesion portion. Then, an injection needle not
shown is pulled out of a treatment instrument channel not shown.
[0079] Subsequently, the existing high-frequency knife is inserted into the treatment instrument
channel and high-frequency current is supplied thereto, thereby forming a hole which
is a start point of the entire peripheral cut-out. Then, the submucosal layer is exposed
while cutting out the mucous membrane around the pathological lesion portion.
[0080] And by pulling the high-frequency knife out of the channel and allowing the slider
16 to retreat relative to the operating portion body 15, in a state where the knife
portion 43 is housed in the sheath 2. the sheath 2 of the high-frequency treatment
instrument 40 is inserted into the treatment instrument channel.
[0081] The distal end of the sheath 2 is exposed from the channel and then the slider 16
is made to move to the distal end side of the operating portion body 15. At this time,
until the connection member 46 is locked to the control member 47, the operating wire
42 is made to advance relative to the sheath 2, and thus the treatment electrode 41
protrudes from the sheath 2. Then, high-frequency current is made to flow therein
while the knife portion 43 comes in contact with the submucosal layer, and the sheath
2 of the high-frequency treatment instrument 40 is made to advance relative to the
channel while observing with the endoscope.
[0082] When the cut-out angle is to be changed, the operating portion 7 is made to rotate
relative to the endoscope. At this time, a rotation torque is transmitted to the treatment
electrode 41 via the operating wire 42 and thus the treatment electrode rotates around
the center line C, thereby changes the direction of the knife portion 43. In this
way, the submucosal layer is cut out by the knife portion 43 and thus the pathological
lesion portion is dissected.
[0083] According to the high-frequency treatment instrument 40, since the knife portion
43 of the treatment electrode 41 is extended in the direction substantially perpendicular
to the operating wire 42, it is possible to enhance the contact area between the treatment
electrode 41 and the pathological lesion portion. In addition, by operating the operating
wire 42 so as to advance and retreat, it is possible to bring the treatment electrode
41 into contact with the pathological lesion portion with an appropriate contact area.
[0084] In addition, because the operating wire 42 and the treatment electrode 41 are disposed
to freely advance and retreat and to freely rotate relative to the sheath 2, when
an approach angle of the knife portion 43 relative to the pathological lesion portion
is to be changed, rotating only the operating wire 42 without rotating the whole sheath
2 is required, thereby reduces required rotation torque and facilitates the rotation.
[0085] The technical scope of the invention is not limited to the above-mentioned embodiments
but various modifications may be made therein without departing from the gist of the
invention.
[0086] For example, in the third embodiment, as shown in FIG. 13, a high-frequency treatment
instrument 52 may be configured such that a relay portion 51 of a treatment electrode
50 is inclined relative to the center line C of the operating wire 42.
[0087] In the first embodiment, as shown in FIG. 14, by stopping the operation at any position
in the way of opening or closing of the pair of electrode pieces 11 A and 11 B, it
is possible to form a mountain-shaped cut-out surface 53 in which the proximal side
angle formed by the knife portions 3 is less than 180 degrees. That is, it is possible
to adjust the width of the cut-out surface.
[0088] Further in the first embodiment, instead of the electrode piece 11 A of the treatment
electrode 5, as shown in FIG. 15. a high-frequency treatment instrument 57 including
a treatment electrode 56 having an electrode piece 55A without the convex portion
12A may be used. In this case, by further moving the slider 16 to the distal end side
relative to the operating portion body 15, a valley-shaped cut-out surface 58A may
be formed in which the proximal side angle formed by the knife portions 3 is greater
than 180 degrees. Accordingly, it is possible to stabilize the cutting direction of
the knife portions 3 in a state where a pathological lesion portion is placed in the
valley-shaped portion of the knife portions 3.
[0089] While preferred embodiments of the invention have been described and illustrated
above, it should be understood that these are exemplary of the invention and are not
to be considered as limiting. Accordingly, the invention is not to be considered as
being limited by the foregoing description, and is only limited by the scope of the
appended claims.
1. A high-frequency treatment instrument (1, 20, 40, 52, 57) for performing a high-frequency
treatment on a subject tissue, the high-frequency treatment instrument (1, 20, 40,
52, 57) comprising:
an elongated extension member (2); and
a treatment electrode (5, 21, 56) which is rotatably connected around an axis of rotation
(10) provided at a distal end of the elongated extension member (2) and which has
a knife portion (3, 27) extending substantially parallel to a diameter direction of
said rotation, wherein
the elongated extension member (2) is formed in a tube shape, and
the high-frequency treatment instrument (1, 20, 57) further comprises an axial member
(6) which is rotatably connected to the treatment electrode (5, 21, 56) and which
advances and retreats relative to the elongated extension member (2) to rotate the
treatment electrode (5, 21, 56), characterized in that
a distal end of the axial member (6) is rotatable around the axis of rotation (10).
2. The high-frequency treatment instrument (1, 20, 57) according to claim 1, wherein
the treatment electrode (5, 21, 56) has a pair of electrode pieces (11A, 11B) which
rotate reversely to each other around the same axis of rotation (10), and wherein
each of the pair of electrode pieces (11A, 11B) has the knife portion (3, 27).
3. The high-frequency treatment instrument (1, 20, 57) according to claim 1 or 2, wherein
the knife portion (3, 27) rotates from a state where the knife portion (3, 27) is
substantially parallel to a center line direction of the elongated extension member
(2) to a state where the knife portion (3, 27) is substantially perpendicular to the
center line direction.
4. The high-frequency treatment instrument (1, 20, 57) according to claim 1 or 2, wherein
the knife portion (3, 27) has a length longer than the outer diameter of the elongated
extension member (2).
5. The high-frequency treatment instrument (1, 20, 57) according to claim 1, wherein
the axial member (6) is rotatably provided with respect to the elongated extension
member (2), and
the treatment electrode (5, 21, 56) which is disposed at a distal end of the axial
member (6) so as to advance and retreat in the elongated extension member (2) along
with the axial member (6) and which has a knife portion (3, 27) extending in a direction
substantially perpendicular to a center line (C) of the axial member (6) as the axial
member (6) being a center.
1. Hochfrequenzbehandlungsinstrument (1, 20, 40, 52, 57) zum Durchführen einer Hochfrequenzbehandlung
an einem Gewebe eines Patienten, wobei das Hochfrequenzbehandlungsinstrument (1, 20,
40, 52, 57) umfasst:
ein längliches Verlängerungselement (2); und
eine Behandlungselektrode (5, 21, 56), die um eine Drehachse (10), die an einem distalen
Ende des länglichen Verlängerungselements (2) vorgesehen ist, drehbar angebracht ist,
und die einen Messerabschnitt (3, 27) aufweist, der sich im Wesentlichen parallel
zu einer Durchmesserrichtung der Drehung erstreckt, wobei
das längliche Verlängerungselement (2) in einer Röhrenform ausgebildet ist, und
das Hochfrequenzbehandlungsinstrument (1, 20, 57) des Weiteren ein axiales Element
(6) umfasst, das drehbar mit der Behandlungselektrode (5, 21, 56) verbunden ist und
relativ zu dem länglichen Verlängerungselement (2) ausfährt und einfährt, um die Behandlungselektrode
(5, 21, 56) zu drehen, dadurch gekennzeichnet, dass
ein distales Ende des axialen Elementes (6) um die Drehachse (10) herum gedreht werden
kann.
2. Hochfrequenzbehandlungsinstrument (1, 20, 57) nach Anspruch 1, wobei
die Behandlungselektrode (5, 21, 56) ein Paar Elektrodenteile (11A, 11B) aufweist,
die sich entgegengesetzt zueinander um die gleiche Drehachse (10) herum drehen, und
wobei
jedes des Paars von Elektrodenteilen (11A, 11B) den Messerabschnitt (3, 27) aufweist.
3. Hochfrequenzbehandlungsinstrument (1, 20, 57) nach Anspruch 1 oder 2, wobei
sich der Messerabschnitt (3, 27) von einem Zustand, in dem der Messerabschnitt (3,
27) im Wesentlichen parallel zu einer Mittellinienrichtung des länglichen Verlängerungselementes
(2) ist, zu einem Zustand dreht, in dem der Messerabschnitt (3, 27) im Wesentlichen
senkrecht zu der Mittellinienrichtung ist.
4. Hochfrequenzbehandlungsinstrument (1, 20, 57) nach Anspruch 1 oder 2, wobei
der Messerabschnitt (3, 27) eine Länge hat, die länger ist als der Außendurchmesser
des länglichen Verlängerungselementes (2).
5. Hochfrequenzbehandlungsinstrument (1, 20, 57) nach Anspruch 1, wobei das axiale Element
(6) in Bezug auf das längliche Verlängerungselement (2) drehbar vorgesehen ist, und
die Behandlungselektrode (5, 21, 56) an einem distalen Ende des axialen Elementes
(6) so vorgesehen ist, dass sie zusammen mit dem axialen Element (6) in dem länglichen
Verlängerungselement (2) ausfährt und einfährt, und sie einen Messerabschnitt (3,
27) aufweist, der sich in einer Richtung im Wesentlichen senkrecht zu einer Mittellinie
(C) des axialen Elementes (6) mit dem axialen Element (6) als einem Mittelpunkt erstreckt.
1. Instrument de traitement haute fréquence (1, 20, 40, 52, 57) destiné à réaliser un
traitement haute fréquence sur un tissu de sujet, l'instrument de traitement haute
fréquence (1, 20, 40, 52, 57) comprenant:
un élément d'extension allongé (2) ; et
une électrode de traitement (5, 21, 56) qui est connectée en rotation autour d'un
axe de rotation (10) prévu au niveau d'une extrémité distale de l'élément d'extension
allongé (2) et qui comporte une partie de couteau (3, 27) s'étendant sensiblement
parallèle au sens du diamètre de ladite rotation, dans lequel
l'élément d'extension allongé (2) est formé selon la forme d'un tube, et
l'instrument de traitement haute fréquence (1, 20, 57) comprend en outre un élément
axial (6) qui est connecté en rotation à l'électrode de traitement (5, 21, 56) et
qui avance et recule par rapport à l'élément d'extension allongé (2) pour faire tourner
l'électrode de traitement (5, 21, 56), caractérisé en ce que
une extrémité distale de l'élément axial (6) est rotative autour de l'axe de rotation
(10).
2. Instrument de traitement haute fréquence (1, 20, 57) selon la revendication 1, dans
lequel
l'électrode de traitement (5, 21, 56) comporte une paire de parties d'électrode (11A,
11B) qui tournent en sens inverse l'une par rapport à l'autre autour du même axe de
rotation (10), et dans lequel
chacune de la paire de parties d'électrode (11A, 11B) comporte la partie de couteau
(3, 27).
3. Instrument de traitement haute fréquence (1, 20, 57) selon la revendication 1 ou 2,
dans lequel
la partie de couteau (3, 27) tourne d'un état dans lequel la partie de couteau (3,
27) est sensiblement parallèle à une direction de ligne centrale de l'élément d'extension
allongé (2) à un état dans lequel la partie de couteau (3, 27) est sensiblement perpendiculaire
à la direction de la ligne centrale.
4. Instrument de traitement haute fréquence (1, 20, 57) selon la revendication 1 ou 2,
dans lequel
la partie de couteau (3, 27) présente une longueur plus longue que le diamètre externe
de l'élément d'extension allongé (2).
5. Instrument de traitement haute fréquence (1, 20, 57) selon la revendication 1, dans
lequel
l'élément axial (6) est prévu de façon rotative par rapport à l'élément d'extension
allongé (2), et
l'électrode de traitement (5, 21, 56) est disposée au niveau d'une extrémité distale
de l'élément axial (6) de façon à avancer et reculer dans l'élément d'extension allongé
(2) avec l'élément axial (6) et comporte une partie de couteau (3, 27) s'étendant
dans une direction sensiblement perpendiculaire à une ligne centrale (C) de l'élément
axial (6), l'élément axial (6) étant un centre.